House of Delegates Handbook AND Addendum combined

1018 Pages·2017·12.26 MB·English

HOUSE
OF
DELEGATES
HANDBOOK
2018 ANNUAL MEETING
Hyatt Regency Chicago | June 9–13
#AMAmtg
#MembersMoveMedicine
@AmerMedicalAssn
Visit ama-assn.org/about/business-ama-house-delegates-2018-
annual-meeting to access the handbook online.
© 2018 American Medical Association. All rights reserved. AI22:18-211009:PDF:5/18
MEMORANDUM FROM THE SPEAKER OF
THE HOUSE OF DELEGATES

• All Delegates, Alternate Delegates and others receiving this material are
reminded that it refers only to items to be considered by the House.

• No action has been taken on anything herein contained, and it is
informational only.

• Only those items that have been acted on finally by the House can be
considered official.

• REMINDER: Only the Resolve portions of the resolutions are considered
by the House of Delegates. The Whereas portions or preambles are
informational and explanatory only.
UNDERSTANDING THE RECORDING OF AMERICAN MEDICAL ASSOCIATION POLICY

Current American Medical Association (AMA) policy is catalogued in PolicyFinder, an electronic database
that is updated after each AMA House of Delegates (HOD) meeting and available online. Each policy is
assigned to a topical or subject category. Those category headings are alphabetical, starting with “abortion”
and running to “women”; the former topic was assigned the number 5, and “women” was assigned 525.
Within a category, policies are assigned a 3 digit number, descending from 999, meaning that older policies
will generally have higher numbers within a category (eg, 35.999 was initially adopted before 35.984). A
policy number is not affected when it is modified, however, so a higher number may have been altered more
recently than a lower number. Numbers are deleted and not reused when policies are rescinded.

AMA policy is further categorized into one of four types, indicated by a prefix:

• “H” – for statements that one would consider positional or philosophical on an issue
• “D” – for statements that direct some specific activity or action. There can be considerable overlap
between H and D statements, with the assignment made on the basis of the core nature of the statement.
• “G” – for statements related to AMA governance
• “E” – for ethical opinions, which are the recommendations put forward in reports prepared by the
Council on Ethical and Judicial Affairs and adopted by the AMA-HOD

AMA policy can be accessed at ama-assn.org/go/policyfinder.

The actions of the AMA-HOD in developing policy are recorded in the Proceedings, which are
available online as well. Annotations at the end of each policy statement trace its development, from initial
adoption through any changes. If based on a report, the annotation includes the following abbreviations:
BOT – Board of Trustees CME – Council on Medical Education
CCB – Council on Constitution and Bylaws CMS – Council on Medical Service
CEJA – Council on Ethical and Judicial Affairs CSAPH – Council on Science and Public Health
CLRPD – Council on Long Range Planning and Development
If a resolution was involved, “Res” is indicated. The number of the report or resolution and meeting (A for
Annual; I for Interim) and year (two digits) are also included (eg, BOT Rep. 1, A-14 or Res. 319, I-12).

AMA policy is recorded in the following categories, and any particular policy is recorded in only a single
category.

5.000 Abortion 10.000 Accident Prevention/Unintentional Injuries
15.000 Accident Prevention: Motor Vehicles 20.000 Acquired Immunodeficiency Syndrome
25.000 Aging 30.000 Alcohol and Alcoholism
35.000 Allied Health Professions 40.000 Armed Forces
45.000 Aviation Medicine 50.000 Blood
55.000 Cancer 60.000 Children and Youth
65.000 Civil and Human Rights 70.000 Coding and Nomenclature
75.000 Contraception 80.000 Crime
85.000 Death and Vital Records 90.000 Disabled
95.000 Drug Abuse 100.000 Drugs
105.000 Drugs: Advertising 110.000 Drugs: Cost
115.000 Drugs: Labeling and Packaging 120.000 Drugs: Prescribing and Dispensing
125.000 Drugs: Substitution 130.000 Emergency Medical Services
135.000 Environmental Health 140.000 Ethics
145.000 Firearms: Safety and Regulation 150.000 Foods and Nutrition
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155.000 Health Care Costs 160.000 Health Care Delivery
165.000 Health Care/System Reform 170.000 Health Education
175.000 Health Fraud 180.000 Health Insurance
185.000 Health Insurance: Benefits and Coverage 190.000 Health Insurance: Claim Forms and Claims
Processing
195.000 Health Maintenance Organizations 200.000 Health Workforce
205.000 Health Planning 210.000 Home Health Services
215.000 Hospitals 220.000 Hospitals: Accreditation Standards
225.000 Hospitals: Medical Staff 230.000 Hospitals: Medical Staff - Credentialing and
Privileges
235.000 Hospitals: Medical Staff - Organization 240.000 Hospitals: Reimbursement
245.000 Infant Health 250.000 International Health
255.000 International Medical Graduates 260.000 Laboratories
265.000 Legal Medicine 270.000 Legislation and Regulation
275.000 Licensure and Discipline 280.000 Long-Term Care
285.000 Managed Care 290.000 Medicaid and State Children's Health Insurance
Programs
295.000 Medical Education 300.000 Medical Education: Continuing
305.000 Medical Education: Financing and Support 310.000 Medical Education: Graduate
315.000 Medical Records and Patient Privacy 320.000 Medical Review
330.000 Medicare 335.000 Medicare: Carrier Review
340.000 Medicare: PRO 345.000 Mental Health
350.000 Minorities 355.000 National Practitioner Data Bank
360.000 Nurses and Nursing 365.000 Occupational Health
370.000 Organ Donation and Transplantation 373.000 Patients
375.000 Peer Review 380.000 Physician Fees
383.000 Physician Negotiation 385.000 Physician Payment
390.000 Physician Payment: Medicare 400.000 Physician Payment: Medicare - RBRVS
405.000 Physicians 406.000 Physician-Specific Health Care Data
410.000 Practice Parameters 415.000 Preferred Provider Arrangements
420.000 Pregnancy and Childbirth 425.000 Preventive Medicine
430.000 Prisons 435.000 Professional Liability
440.000 Public Health 445.000 Public Relations
450.000 Quality of Care 455.000 Radiation and Radiology
460.000 Research 465.000 Rural Health
470.000 Sports and Physical Fitness 475.000 Surgery
478.000 Technology - Computer 480.000 Technology - Medical
485.000 Television 490.000 Tobacco Use, Prevention and Cessation
495.000 Tobacco Products 500.000 Tobacco: AMA Corporate Policies and Activities
505.000 Tobacco: Federal and International Policies 510.000 Veterans Medical Care
515.000 Violence and Abuse 520.000 War
525.000 Women 600.000 Governance: AMA House of Delegates
605.000 Governance: AMA Board of Trustees and Officers 610.000 Governance: Nominations, Elections, and
Appointments
615.000 Governance: AMA Councils, Sections, and 620.000 Governance: Federation of Medicine
Committees
625.000 Governance: Strategic Planning 630.000 Governance: AMA Administration and Programs
635.000 Governance: Membership 640.000 Governance: Advocacy and Political Action
LIST OF MATERIAL INCLUDED IN THIS HANDBOOK (A-18)
Resolutions and reports have been collated by referral according to reference committee assignment. In the
listing below, referral is indicated by letter in parenthesis following the title of the report. Resolutions have
been numbered according to referrals (i.e., those referred to the Reference Committee on Amendments to
Constitution and Bylaws begin with 1, Reference Committee B begins with 201, etc.).
The informational reports contain no recommendations and will be filed on Sunday, June 10, unless a request
is received for referral and consideration by a Reference Committee (similar to the use of a consent calendar).
1. Memorandum from the Speaker
2. Understanding the Recording of American Medical Association Policy
3. Declaration of Professional Responsibility - Medicine's Social Contract with Humanity
4. Delegate / Alternate Delegate Job Description, Roles and Responsibilities
5. Seating Allocation and Seating Chart for the House of Delegates
6. Hotel Maps
7. Official Call to the Officers and Members of the AMA
Listing of Delegates and Alternate Delegates
Officials of the Association and AMA Councils
House of Delegates Reference Committee Members
8. Note on Order of Business
9. Summary of Fiscal Notes
FOLLOWING COLLATED BY REFERRAL
10. Report(s) of the Board of Trustees - Gerald E. Harmon, MD, Chair
01 Annual Report (F)
02 New Specialty Organizations Representation in the House of Delegates (Amendments to C&B)
03 2017 Grants and Donations (Info. Report)
04 AMA 2019 Dues (F)
05 Update on Corporate Relationships (Info. Report)
06 Redefining AMA's Position on ACA and Healthcare Reform (Info. Report)
07 AMA Performance, Activities and Status in 2017 (Info. Report)
08 Annual Update on Activities and Progress in Tobacco Control: March 2017 Through February 2018
(Info. Report)
09 Council on Legislation Sunset Review of 2008 House Policies (B)
10 Over-the-Counter Contraceptive Drug Access (E)
11 Housing Provision and Social Support to Immediately Alleviate Chronic Homelessness in the
United States (D)
12 Advocacy for Seamless Interface Between Physician Electronic Health Records, Pharmacies and
Prescription Drug Monitoring Programs (B)
13 Mergers of Secular and Religiously Affiliated Health Care Institutions and Their Impact on Patient
Care and Access to Services (Amendments to C&B)
14 Integration of Drug Price Information into Electronic Medical Records / Barriers to Price
Transparency / Bidirectional Communication for EHR Software and Pharmacies / Health Plan,
Pharmacy, Electronic Health Records Integration (B)
15 Advanced Practice Registered Nurse Compact (B)
16 Protection of Clinician-Patient Privilege (B)
17 Evaluating Actions by Pharmacy Benefit Manager and Payer Policies on Patient Care (B)
18 Medical Liability Coverage Through the Federal Tort Claims Act (B)
19 Health Information Technology Principles (B)
20 Anti-Harassment Policy (F)
21 Ownership of Patient Data (Info. Report)
22 In-Flight Emergencies (E)
23 Healthcare as a Human Right (Amendments to C&B)
24 Appropriate Placement of Transgender Prisoners (Amendments to C&B)
25 Recognition of Physician Orders for Life Sustaining Treatment Forms (Amendments to C&B)
26 Revision of Researcher Certification and Institutional Review Board Protocols (Amendments to
C&B)
27 Policy and Economic Support for Early Child Care (D)
28 Mandatory Public Health Reporting of Law-Enforcement-Related Injuries and Deaths (D)
29 Support for Service Animals, Emotional Support Animals, Animals in Healthcare and Medical
Benefits of Pet Ownership (E)
30 In-Flight Emergencies (E)
31 Physician Burnout and Wellness Challenges, Physician and Physician Assistant Safety Net,
Identification and Reduction of Physician Demoralization (G)
32 Studying Healthcare Institutions that Provide Child Care Services (Info. Report)
33 Plan for Continued Progress Toward Health Equity (F)
34 AMA to Protect Human Health from the Effects of Climate Change by Ending its Investments in
Fossil Fuel Companies (F)
35 Model Hospital Medical Staff Bylaws (F)
36 Management of Physician and Medical Student Stress (Info. Report)
37 Eliminate the Requirement of H&P Update (G)
38 Timely Referral to Pain Management Specialist (E)
39 Expanding Access to Screening Tools for Social Determinants of Health/Social Determinants of
Health in Payment Models (G)
40 Medicare Coverage of Services Provided by Proctored Medical Students (A)
41 Augmented Intelligence in Health Care (B)
42 Demographic Report of the House of Delegates and AMA Membership (Info. Report)
11. Report(s) of the Council on Constitution and Bylaws - Colette R. Willins, MD, Chair
01 CCB Sunset Review of 2008 House Policies (Amendments to C&B)
12. Report(s) of the Council on Ethical and Judicial Affairs - Dennis S. Agliano, MD, Chair
01 Competence, Self-Assessment and Self-Awareness (Amendments to C&B)
02 Mergers of Secular and Religiously Affiliated Health Care Institutions (Amendments to C&B)
03 Medical Tourism (Amendments to C&B)
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04 Expanded Access to Investigational Therapies (Amendments to C&B)
05 Study Aid-in-Dying as End-of-Life Option / The Need to Distinguish "Physician Assisted Suicide"
and "Aid in Dying" (Amendments to C&B)
06 CEJA's Sunset Review of 2008 House Policies (Amendments to C&B)
07 Judicial Function of the Council on Ethical and Judicial Affairs - Annual Report (Info. Report)
13. Opinion(s) of the Council on Ethical and Judicial Affairs - Dennis S. Agliano, MD, Chair
01 Ethical Physician Conduct in the Media (Info. Report)
14. Report(s) of the Council on Long Range Planning and Development - Glenn A. Loomis, MD, Chair
01 A Primer on Artificial and Augmented Intelligence (Info. Report)
15. Report(s) of the Council on Medical Education - Lynne M. Kirk, MD, Chair
01 Council on Medical Education Sunset Review of 2008 House of Delegates Policies (C)
02 Update on Maintenance of Certification and Osteopathic Continuous Certification (C)
03 Expanding UME Without Concurrent GME Expansion (C)
04 Evaluation of Clinical Documentation Training (C)
05 Study of Declining Native American Medical Student Enrollment (Info. Report)
06 Mental Health Disclosures on Physician Licensing Applications (C)
16. Report(s) of the Council on Medical Service - Paul A. Wertsch, MD, Chair
01 Council on Medical Service Sunset Review of 2008 AMA House Policies (A)
02 Improving Affordability in the Health Insurance Exchanges (A)
03 Ensuring Marketplace Competition and Health Plan Choice (A)
04 Health Plans' Medical Advice (G)
05 Financing of Long-Term Services and Supports (G)
06 Integrating Precision Medicine into Alternative Payment Models (G)
07 Insulin Affordability (A)
08 Addressing the Site-of-Service Differential (Info. Report)
17. Report(s) of the Council on Science and Public Health - Robert A. Gilchick, MD, Chair
01 CSAPH Sunset Review of 2008 House of Delegates Policies (D)
02 Drug Shortages: Update (E)
03 Prescription Drug Donation (E)
04 The Physician's Role in Firearm Safety (D)
05 Tobacco Harm Reduction: A Comprehensive Nicotine Policy to Reduce Death and Disease Caused
by Smoking (D)
18. Report(s) of the HOD Committee on Compensation of the Officers - Brooks F. Bock, MD, Chair
01# Report of the HOD Committee on Compensation of the Officers (F)
19. Joint Report(s)
01 CMS/CSAPH Joint Report - Coverage for Colorectal Cancer Screening (A)
20. Report(s) of the Speakers - Susan R. Bailey, MD, Speaker; Bruce A. Scott, MD, Vice Speaker
01 Recommendations for Policy Reconciliation (Info. Report)
21. Resolutions
001 Discriminatory Policies that Create Inequities in Health Care (Amendments to C&B)
002 FMLA-Equivalent for LGBT Workers (Amendments to C&B)
003 Proposing Consent for De-Identified Patient Information (Amendments to C&B)
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004 Patient-Reported Outcomes in Gender Confirmation Surgery (Amendments to C&B)
005 Decreasing Sex and Gender Disparities in Health Outcomes (Amendments to C&B)
006 Living Donor Protection Act of 2017 (HR 1270) (Amendments to C&B)
007 Oppose the Criminalization of Self-Induced Abortion (Amendments to C&B)
008 Health Care Rights of Pregnant Minors (Amendments to C&B)
009 Improving and Increasing Clarity and Consistency Among AMA Induced Abortion Policies
(Amendments to C&B)
010 Gender Equity in Compensation and Professional Advancement (Amendments to C&B)
011 Women Physician Workforce and Gender Gap in Earnings - Measures to Improve Equality
(Amendments to C&B)
012 Costs to Kidney Donors (Amendments to C&B)
013 Opposing Surgical Sex Assignment of Infants with Differences of Sex Development (Amendments
to C&B)
014 Promotion of LGBTQ-Friendly and Gender-Neutral Intake Forms (Amendments to C&B)
015 Human Trafficking / Slavery Awareness (Amendments to C&B)
016# Utilization of "LGBTQ" in Relevant Past and Future AMA Policies (Amendments to C&B)
017# Revised Mission Statement of the AMA (Amendments to C&B)
101 Medicaid Reform (A)
102 Effectiveness of Risk Assessment Models in Representing Healthcare Resources Expended for
Infants and Children (A)
103 Oppose Medicaid Eligibility Lockout (A)
104 Emergency Out of Network Services (A)
105 Use of High Molecular Weight Hyaluronic Acid (A)
106 Prohibit Retrospective ER Coverage Denial (A)
107 Opposition to Medicaid Work Requirement (A)
108 Expanding AMA's Position on Healthcare Reform Options (A)
109 Medicaid Coverage of Fitness Facility Memberships (A)
110 Return to Prudent Layperson Standard for Emergency Services (A)
111 Medicare Coverage for Dental Services (A)
112 Enabling Attending Physicians to Waive the Three-midnight Rule for Patients Receiving Care
within Downside Risk Sharing Accountable Care Organizations and Advance Bundled Payments Care
Improvement Programs (A)
113 Survivorship Care Plans (A)
114 Inclusion of Bundled Payments Care Improvement (BPCI) Post-Acute only Model 3 in Advanced
BPCI (A)
115# Expanding On-Site Physician Home Health Care to Low-Income Families and the Chronically Ill
(A)
116# Ban on Medicare Advantage "No Cause" Network Terminations (A)
201 Removing Barriers to Obesity Treatment (B)
202 Universal and Standardized Protocols for EHR Data Transition (B)
203 Updating Federal Food Policy to Improve Nutrition and Health (B)
204 Opposition to Mandated Proficiency in EHR for Licensure (B)
205 Augmented Intelligence (B)
206 Appropriate Use of Telehealth Services (B)
207 Quality Improvement Requirements (B)
208 Prior Authorization Requirements for Post-Operative Opioids (B)
209 Substance Use Disorders During Pregnancy (B)
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210 Banning the Sale of Bump Stocks (B)
211 Clarification from U.S. Department of Justice Regarding Federal Enforcement of Medical
Marijuana Laws (B)
212 Value-Based Payment System (B)
213 Utilization Review (B)
214 Strengthening the Background Check System for Firearm Sales (B)
215 Regulation of Hospital Advertising (B)
216 FDA Conflict of Interest (B)
217 Reforming the Orphan Drug Act (B)
218 Considering Feminine Hygiene Products as Medical Necessities (B)
219 Improving Medicare Patients' Access to Kidney Transplantation (B)
220 Ban on Semi-Automatic Assault Weapons and High Capacity Ammunition Magazines (B)
221 Maintaining Validity and Comprehensiveness of U.S. Census Data (B)
222# Evidence Based Treatment in Substance Abuse Treatment Facilities (REVISED) (B)
223 Treating Opioid Use Disorder in Hospitals (B)
224 Legalization of Interpharmacy Transfer of Electronic Controlled Substance Prescriptions (B)
225 Pharmacy Benefit Managers Impact on Patients (B)
226 Model State Legislation for Routine Preventative Prostate Cancer Screening for Men Ages 55-69
(B)
227 An Optional National Prescription Drug Formulary (B)
228 Medicare Quality Incentives (B)
229 Green Card Backlog for Immigrant Doctors on H-1B Visa (B)
230 Opposition to Funding Cuts for Programs that Impact the Health of Populations (B)
231 Online Controlled Drugs (B)
232 Recording Law Reform (B)
233 Support for Reauthorization of the Supplemental Nutrition Assistance Program (B)
234 Support for Primary Care Enhancement Act (B)
235 Hospital Consolidation (B)
236 Reducing MIPS Reporting Burden (B)
237 Safe and Efficient E-Prescribing (B)
238 Reform of Pharmaceutical Pricing: Negotiated Payment Schedules (B)
239 Treating Opioid Use Disorder in Hospitals (B)
240 Treating Opioid Use Disorder in Treatment Facilities (B)
241 Accuracy and Accountability of Physician Compensation Reporting by Drug and Device
Companies (B)
242 Pharmacy Benefit Managers and Compounded Medications (B)
243 Report Health Care Provider Sex Crimes to Law Enforcement (B)
244# Increasing the Legal Age of Purchasing Ammunition and Firearms from 18 to 21 (B)
245# Opposing NCOIL Attempts to Stop Physician Dispensing (B)
246# Support for Patients and Physicians in Direct Primary Care (B)
247# Opposed Replacement of the Merit-Based Incentive Payment System with the Voluntary Value
Program (B)
248# Opposition to Firearm Concealed Carry Reciprocity (B)
249# Support Any Willing Provider Legislation (B)
301 Protecting Medical Trainees from Hazardous Exposure (C)
302 For-Profit Medical Schools or Colleges (C)
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303 Fellowship Start Date (C)
304 Persons With Intellectual and Developmental Disabilities Designated as a Medically Underserved
Population (C)
305 Standardization of Medical Licensing Time Limits Across States (C)
306 Sex and Gender Based Medicine (C)
307 Healthcare Finance in the Medical School Curriculum (C)
308 Foreign Trained IMGs Obtaining a U.S. License Without U.S. Residency (C)
309 Foreign Trained IMGs Competency-Based Specialty Exam Without U.S. Residency (C)
310 U.S. Institutions With Restricted Medical Licensure (C)
311 Opioid Education for New Trainees (C)
312 Suicide Awareness Training (C)
313 Financial Literacy for Medical Students and Residents (C)
314 Board Certification Changes Impact Access to Addiction Medicine Specialists (C)
315 Peer-Facilitated Intergroup Dialogue (C)
316 End "Part 4 Improvement in Medical Practice" Requirement for ABMS MOC (C)
317# Emerging Technologies (Robotics and AI) in Medical School Education (C)
318# AMA Convene Stakeholders to Transition USMLE to Pass / Fail Scoring (C)
401 Danger from Bright Vehicle Headlights (D)
402 Schools as Gun-Free Zones (D)
403 School Safety and Mental Health (D)
404 Emphasizing the Human Papillomavirus Vaccines as Anti-Cancer Prophylaxis for a Gender-
Neutral Demographic (D)
405 Racial Housing Segregation as a Determinant of Health and Public Access to Geographic
Information Systems (GIS) Data (D)
406 Support for Public Health Violence Prevention Programs (D)
407 Support for Research of Boxes for Babies' Sleeping Environment (D)
408 Ending Money Bail to Decrease Burden on Lower Income Communities (D)
409 Food Advertising Targeted to Black and Latino Youth Contributes to Health Disparities (D)
410 Opposition to Measures that Criminalize Homelessness (D)
411 Reporting Child Abuse in Military Families (D)
412 Reducing the Use of Restrictive Housing in Prisoners with Mental Illness (D)
413 Improving Safety and Health Code Compliance in School Facilities (D)
414 Sex Education Materials for Students with Limited English Proficiency (D)
415 Reducing Gun Violence in America (D)
416 Medical Respite Care for Homeless Adults (D)
417 Reducing Disparities in Obstetric Outcomes, Maternal Morbidity, and Prenatal Care (D)
418 A Guide for Best Health Practices for Seniors Living in Retirement Communities (D)
419 Violence Prevention (D)
420 Mandatory Influenza Vaccination Policies for Healthcare Workers (D)
421 Product Date Labels (D)
422 School Drinking Water Quality Testing, Monitoring, and Maintenance (D)
423 Grill Brush Warning (D)
424 Rape and Sexual Abuse on College Campuses (D)
425 Hospital Food Labeling (D)
426# Decrease Adolescent Mortality Through More Comprehensive Graduated Driver Licensing
Programs (D)
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